Coustan D R, Nelson C, Carpenter M W, Carr S R, Rotondo L, Widness J A
Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence.
Obstet Gynecol. 1989 Apr;73(4):557-61.
The American College of Obstetricians and Gynecologists (ACOG) has recommended screening for gestational diabetes, using a 50-g, 1-hour glucose challenge (threshold for further testing 140 mg/dL or higher), for all pregnant women aged 30 or older and for younger women with risk factors. In order to assess these recommendations, we collected demographic and historic data on 6214 pregnant women representing a population of universally screened individuals. Of 125 cases of gestational diabetes diagnosed (ACOG criteria), 70 patients (56%) were under the age of 30. In addition, 44% of gestational diabetics had no risk factors. The cost per case diagnosed would be $190 with the ACOG recommendations, $192 if the age for routine screening were lowered to 25 years or more, and $222 if universal screening were practiced. Using the ACOG recommendations, 35% of gestational diabetes would go undiagnosed, with little cost savings.
美国妇产科医师学会（ACOG）建议，对所有30岁及以上的孕妇以及有危险因素的年轻孕妇，采用50克1小时血糖筛查（进一步检查的阈值为140毫克/分升或更高）来筛查妊娠期糖尿病。为了评估这些建议，我们收集了6214名孕妇的人口统计学和病史数据，这些孕妇代表了接受普遍筛查的人群。在诊断出的125例妊娠期糖尿病病例（采用ACOG标准）中，70例患者（56%）年龄在30岁以下。此外，44%的妊娠期糖尿病患者没有危险因素。按照ACOG的建议，每诊断出一例病例的成本为190美元；如果将常规筛查年龄降低到25岁及以上，成本为192美元；如果进行普遍筛查，成本为222美元。按照ACOG的建议，35%的妊娠期糖尿病将无法被诊断出来，且几乎没有成本节约。
